Abstract

BackgroundPsychosocial interventions for people with dementia and their family caregivers together may sustain relationship quality and social connection. No previous music therapy research has examined the effects of group therapeutic songwriting (TSW) attended by people with dementia/family caregiver dyads.MethodsThis pre–post feasibility study aimed to examine the acceptability of a group TSW intervention for people with dementia/family caregiver dyads and test the sensitivity of the following outcomes: Quality of the Caregiver–Patient Relationship (QCPR, primary); Cornell Scale for Depression in Dementia (CSDD) and Quality of Life–Alzheimer’s Dementia for people with dementia, Patient Health Questionnaire-9, Assessment of Quality of Life–8 Dimensions (AQoL-8D); and Zarit Burden Interview for family caregivers. Six weekly 1 h sessions guided participants to identify preferred music, brainstorm ideas, create lyrics, and record songs. Qualitative interviews were conducted with dyads who completed the intervention.ResultsFourteen dyads were recruited and completed baseline assessments. Participants with dementia were aged 62–92 years (M = 77, SD = 11). Caregiver participants (11 spouses, two daughters, one son) were aged 54–92 years (M = 67, SD = 10.1). Four dyads withdrew owing to declining health or inconvenience before the program commenced (n = 2) and after attending 1–2 sessions (n = 2). Ten dyads formed four homogeneous TSW groups (71% completion). No statistically significant changes were detected for any measure. High QCPR ratings at baseline (M = 57.1) and follow-up (M = 57.4) demonstrated sustained relationship quality. For participants with dementia, large effect sizes for the CSDD suggested trends toward decreased depression (d = -0.83) and improved mood (d = -0.88). For family caregivers, a large effect size suggested a trend toward improvement for the AQoL-8D sub-domain examining independent living (d = -0.93). Qualitative data indicated that session design and delivery were acceptable, and TSW was a positive shared experience with personal benefits, which supported rather than changed relationship quality.ConclusionHigh retention and qualitative data indicate that TSW was well received by participants. Effect sizes suggest that group TSW for dyads may have beneficial impacts on depression for people with dementia and quality of life for family caregivers. Future research with a fully powered sample is recommended to further examine the psychosocial impacts of group TSW for people living with dementia/family caregiver dyads.

Highlights

  • Dementia is recognized as an international public health priority (WHO, 2017)

  • People with dementia may experience changes related to cognitive processing, communication, selfcare, mental health, and social connection, which in turn increase the likelihood of depression and anxiety among family caregivers as they manage the needs and autonomy of their family member while attempting to maintain personal identity (Gorska et al, 2018)

  • Aside from withdrawals (n = 4), substantial amounts of missing data for participants with dementia meant that the following cases were excluded from outcome measure analyses: Cornell Scale for Depression in Dementia (CSDD) n = 2 pretest, n = 1 posttest; Quality of Life–Alzheimer’s Dementia (QoL-AD) self-rated n = 3 pretest, n = 4 posttest; QoL-AD proxy-rated n = 2 pretest, n = 3 posttest

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Summary

Introduction

Dementia is recognized as an international public health priority (WHO, 2017). Currently, approximately 50 million people live with a diagnosis of dementia worldwide, making it one of the leading causes of disability among older adults (Guerchet et al, 2016; WHO, 2017). A diagnosis of dementia and associated symptoms, including cognitive decline and changed behaviors, can have significant physical, psychological, and social impacts for the individual, as well as for spouses, other family members, and friends providing informal care ( referred to as family caregivers). People with dementia may experience changes related to cognitive processing, communication, selfcare, mental health, and social connection, which in turn increase the likelihood of depression and anxiety among family caregivers as they manage the needs and autonomy of their family member while attempting to maintain personal identity (Gorska et al, 2018). Psychosocial interventions for people with dementia and their family caregivers together may sustain relationship quality and social connection. No previous music therapy research has examined the effects of group therapeutic songwriting (TSW) attended by people with dementia/family caregiver dyads

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